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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model for Cultural Competence
Larry Purnell, PhD, RN, FAAN
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model: Assumptions
All healthcare professions need much of the same information about cultural diversity and share the metaparadigm concepts of global society, community, family, person, and health.
One culture is not better than another culture; they are just different.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model: Assumptions
There are core similarities shared by all cultures.
There are differences within, between, and among cultures.
Cultures change over time, but slowly.
Culture has powerful influences on one’s interpretations and responses to health care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model: Assumptions
If clients are co-participants in care and have a choice in health-related goals, plans, and interventions, health outcomes will be improved.
Variant cultural characteristics determine the degree to which people vary from their dominant culture beliefs, values, and practices.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model: Assumptions
Individuals and families belong to several cultural groups, usually known as subcultures.
Each individual has the right to be respected for his or her unique differences and cultural heritage.
Caregivers who can assess, plan, and intervene in a culturally competent manner will improve the care of clients for whom they care.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Purnell Model: Assumptions
Caregivers know themselves better by learning about their own cultures.
Professions, organizations, and associations have their own cultures.
Healthcare teams can benefit from a Model and Organizing Framework that is useable by all healthcare disciplines.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Variant Cultural Characteristics
Nationality
Race
Color
Gender
Age
Religious affiliation
Educational status
Socioeconomic status
Occupation
Military experience
Political beliefs
Urban versus rural residence
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Variant Cultural Characteristics
Marital status
Parental status
Physical characteristics
Sexual orientation
Gender issues
Length of time away from the home country
Reason for immigration—sojourner, immigrant, undocumented status
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Metaparadigm Concept: Global Society
Seeing the world as one large community of multicultural people
Evidence of global society
What happens in other parts of the world affects each community
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
ClickerCheck
What determines a person’s adherence with his/her dominant culture?
Metaparadigm concepts
Variant characteristics
Global society
Cultural worldview
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Correct Answer
Correct answer: B
Variant cultural characteristics determine the degree to which a person adheres to his/her dominant cultural beliefs and practices.
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Metaparadigm concept: Community
A group or class of people having a common interest or identity living in a specified locality but can be an online community as well now
What happens in the community has an effect on the family.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Metaparadigm concept: Family
Two or more people who are emotionally involved with each other
They may, but not necessarily, live in close proximity to each other.
What affects the individual, affects the person.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Metaparadigm concept: Person
A human being, one who is constantly adapting to his or her environment biologically, physically, socially, or psychologically
Person is defined differently in other cultures.
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Overview/Heritage
Origins
Residence
Topography
Economics
Politics
Education
Occupation
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Communication
Dominant language and dialects
Contextual use of the language
Paralanguage—volume and tone
Temporality—time—and spatial distancing
Use of touch
Eye contact and facial expressions
Greetings and name format
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Family Organization
Head of household
Gender roles
Goals and priorities
Developmental tasks
Roles of the aged and extended family
Social status
Alternative lifestyles
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Workforce Issues
Acculturation
Autonomy
Language barriers
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Biocultural Ecology
Biological variations
Skin color
Heredity
Genetics
Endemics
Drug metabolism
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: High-Risk Behaviors
Tobacco
Alcohol
Recreational drugs
Physical activity
Safety
Sexual behavior
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Nutrition
Meaning of food
Common foods
Rituals
Deficiencies
Limitations
Health promotion
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Pregnancy and Childbearing
Fertility practices
Views toward pregnancy
Pregnancy beliefs
Birthing practices
Postpartum
Prescriptive, restrictive, and taboo practices
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Death and Dying
Death rituals during the dying process
Post mortem practices
Bereavement
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Spirituality
Religious practices
Use of prayer
Meaning of life
Individual strength
Spirituality and health
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
ClickerCheck
Contextual aspect of cultural communication includes
Dominant language
Dialects
Explicit versus implicit communication
Translation versus interpretation
*
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Correct Answer
Correct answer: C
Contextual use of a language is concerned with the number of words used to express a thought. High-contexted communication uses fewer words to express a thought.
Low-contexted communication uses a lot of words to express a thought
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Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Health-care Practices
Focus of health care
Traditional practices
Magicoreligious beliefs
Responsibility for health
Self-medication practices
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Health-care Practices
Responses to pain
Sick role
Mental health
Rehabilitation
Chronicity
Blood transfusion
Transplantation
Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Domain: Health-care Practitioners
Perceptions of practitioners
Folk practitioners
Gender and health care
Status of healthcare providers
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